Martin KennardMartin Kennard

Leeds Community Leeds Community Equipment and Equipment and

Telecare Services Telecare Services ManagerManager

The Leeds The Leeds Community Community

Equipment Service: Equipment Service: Planning for the Planning for the

FutureFuture

Session contentSession content LCES nowLCES now Assessing our options: whyAssessing our options: why Assessing our options: howAssessing our options: how The options appraisal: service The options appraisal: service

requirements requirements The options appraisal: the service delivery The options appraisal: the service delivery

optionsoptions Making the “decision”Making the “decision” The preferred optionThe preferred option Next steps…Next steps…

LCES Statement of LCES Statement of PurposePurpose

““The aim of the Leeds The aim of the Leeds Community Equipment Community Equipment Service is to provide the right Service is to provide the right equipment quickly to enable equipment quickly to enable people to live independent people to live independent inclusive lives”inclusive lives”

LCES now: budgets LCES now: budgets 2008 - 20092008 - 2009

Expenditure on equipment: Expenditure on equipment: £1,875,075£1,875,075

Running costs: Running costs: £1,000.167£1,000.167

As new value of equipment on As new value of equipment on loan: loan: £10,409,326£10,409,326

LCES now: activity LCES now: activity 2008 - 20092008 - 2009

No. of items issued: No. of items issued: 71,59271,592

No. of items collected: No. of items collected: 50,24450,244

No. of adults: No. of adults: 16,08916,089

No. of children: No. of children: 705705

LCES now: ways of LCES now: ways of workingworking

Most community equipment in Leeds for Most community equipment in Leeds for non self funders is provided by Local non self funders is provided by Local Authority / Health integrated service Authority / Health integrated service directly via main or peripheral stores.directly via main or peripheral stores.

However, certain number of items being However, certain number of items being provided via direct payments and provided via direct payments and prescription for the last two years.prescription for the last two years.

LCES now: assessing our LCES now: assessing our options - whyoptions - why

TCES agendaTCES agenda PersonalisationPersonalisation Ageing populationAgeing population Need to support Need to support allall equipment and other equipment and other

assistive technology (AT) usersassistive technology (AT) users Desire to embrace all aspects of AT, Desire to embrace all aspects of AT,

particularly new developments related to particularly new developments related to Telecare and TelehealthTelecare and Telehealth

LCES now: assessing our LCES now: assessing our options - howoptions - how

Conducted a formal option appraisal using Conducted a formal option appraisal using project management methodologyproject management methodology

““Decision” making process devised and led Decision” making process devised and led by Leeds Metropolitan Universityby Leeds Metropolitan University

Wide stakeholder involvement to validate Wide stakeholder involvement to validate requirements and to ensure credibilityrequirements and to ensure credibility

Use of experts to lead work packages to Use of experts to lead work packages to investigate effect on area of expertise of investigate effect on area of expertise of different service delivery optionsdifferent service delivery options

LCES now: the options LCES now: the options appraisal - service appraisal - service

requirementsrequirements Via stakeholder meetings came up with Via stakeholder meetings came up with

15 service requirements for a future 15 service requirements for a future service:service:

The PO has clear, transparent, auditable The PO has clear, transparent, auditable and effective management, governance and effective management, governance and regulatory arrangementsand regulatory arrangements

The PO complies with relevant major The PO complies with relevant major mandatory national policiesmandatory national policies

LCES now: the options LCES now: the options appraisal - service appraisal - service

requirementsrequirements The PO is based on a sound economic The PO is based on a sound economic

rationalerationale The PO caters to the requirements of The PO caters to the requirements of

service users/customersservice users/customers The PO aligns with major strategies of The PO aligns with major strategies of

LCC and Leeds PCT LCC and Leeds PCT

The options appraisal: The options appraisal: service requirementsservice requirements

The PO serves all population groupsThe PO serves all population groups The PO is an integrated service delivered The PO is an integrated service delivered

by as few providers as possible by as few providers as possible The PO is deliverable within the current The PO is deliverable within the current

versions of LCC/LCES capacity and versions of LCC/LCES capacity and implementation plansimplementation plans

The PO retains a social responsibility The PO retains a social responsibility towards LCES staff and any new starterstowards LCES staff and any new starters

The options appraisal: The options appraisal: service requirementsservice requirements

The PO retains a public service ethosThe PO retains a public service ethos The PO has in place the relevant The PO has in place the relevant

commercial and partnership commercial and partnership arrangements arrangements

The PO is supported by appropriate The PO is supported by appropriate information/ICT requirements information/ICT requirements

The PO complies with TCES agenda The PO complies with TCES agenda

The options appraisal: The options appraisal: service optionsservice options

Option 1: A local store, managed in house + a non-CSED retail component

LCES

Community Equipment Shop

Limited prescription service via direct payments

Local LCC/LPCT managed CES Store (for all equipment)

Existing local CE retailers

Leeds Community Equipment Service

Option 2: A local store contracted out to a third party + a non-CSED retail component

Community Equipment Shop

Local CES Store (for all equipment) contracted out

Limited prescription service via direct payments

Existing local CE retailers

LCES PLC

Leeds Community Equipment Service PLC

Option 3: A local store managed in house for complex items of equipment + a CSED retail component

Community

Equipment Shop +

Local LCC/LPCT managed CES Store (for Complex equipment only)

Full CSED Prescription service

Existing local CE retailers + new entrants (for ‘Aids to Daily Living’)

National Catalogue and Tariff

National Equipment Store Accreditation Body

LCES Complex

Leeds Complex Community Equipment Service

Option 4: A local store contracted out to a third party for complex items of equipment + a CSED retail

component

Community

Equipment Shop +

Local CES Store (for Complex equipment only) contracted out

Full CSED Prescription service

Existing local CE retailers + new entrants (for ‘Aids to Daily Living’)

National Catalogue and Tariff

National Equipment Store Accreditation Body

Leeds Complex Community Equipment Service PLC

LCES Complex PLC

Option 5: A regional store managed in house for complex items of equipment + a CSED retail component

Community

Equipment Shop +

Regional LCC/LPCT managed CES Store (for Complex equipment only)

Full CSED Prescription service

Existing local CE retailers + new entrants (for ‘Aids to Daily Living’)

National Catalogue and Tariff

National Equipment Store Accreditation Body

WYCES Complex

West Yorkshire Complex Community Equipment Service

Option 6: A regional store contracted out to a third party for complex items of equipment + a CSED retail

component

Community

Equipment Shop +

Regional CES Store (for Complex equipment only) contracted out

Full CSED Prescription service

Existing local CE retailers + new entrants (for ‘Aids to Daily Living’)

National Catalogue and Tariff

National Equipment Store Accreditation Body

WYCES Complex PLC

West Yorkshire Complex Community Equipment Service PLC

Making the “decision”Making the “decision”

Making the “decision”Making the “decision”

Structured day with project board and Structured day with project board and other stakeholder delegates scoring the other stakeholder delegates scoring the recommendations against the options recommendations against the options based on the presentations of their findings based on the presentations of their findings by work package leads.by work package leads.

After all scoring complete the weightings After all scoring complete the weightings applied to give final decisionapplied to give final decision

Making the “decision”Making the “decision”

Factors around costs, need for change?, Factors around costs, need for change?, performance of test sites, need for clear performance of test sites, need for clear and open governance, lack of data re. and open governance, lack of data re. regional options, need to meet national regional options, need to meet national and local policy expectations etc. were and local policy expectations etc. were critical in decisions makingcritical in decisions making

The recommendationThe recommendation

Always clear that decision could only be Always clear that decision could only be recommendations for consideration by PCT recommendations for consideration by PCT and LA decision makersand LA decision makers

Agreed that the recommendations would take Agreed that the recommendations would take account of the vote but also the narrative account of the vote but also the narrative which emerged via stakeholder sessions, which emerged via stakeholder sessions, managers meeting, project board meetings managers meeting, project board meetings etc. etc.

The recommendationsThe recommendations

Retain in-house joint service purchasing Retain in-house joint service purchasing and providing much of equipment over £?and providing much of equipment over £?

Put systems in place to provide cash and Put systems in place to provide cash and prescriptions to people using IBsprescriptions to people using IBs

Work with retailers to develop local Work with retailers to develop local market to enable above and take market to enable above and take prescriptions for some items £? and prescriptions for some items £? and underunder

The recommendationsThe recommendations

Explore option for in-house / social Explore option for in-house / social enterprise arm of main service to offer enterprise arm of main service to offer retail sales and retail sales and hirehire service to ensure service to ensure continuity and expertisecontinuity and expertise

The recommendationsThe recommendations

Ensure that Ensure that allall AT users are supported – AT users are supported – including self fundersincluding self funders

Focus on the further development and Focus on the further development and coordination of all AT services in Leedscoordination of all AT services in Leeds

Forge new partnerships between all AT Forge new partnerships between all AT providers (statutory, private and voluntary providers (statutory, private and voluntary sectors)sectors)

Further develop use of Telecare and related Further develop use of Telecare and related technologies technologies

Next steps…Next steps…

Implementation of the preferred option for Implementation of the preferred option for community equipment provision is part of community equipment provision is part of a wider project to develop our assistive a wider project to develop our assistive technology offertechnology offer

Definition of ATDefinition of AT

““AT can be defined as any item, piece AT can be defined as any item, piece of equipment, product or system that is of equipment, product or system that is used to increase maintain or improve used to increase maintain or improve the functional capabilities and the functional capabilities and independence of people with cognitive independence of people with cognitive physical or communication difficulties”.physical or communication difficulties”.

Audit Commission 2004Audit Commission 2004

Developing our Assistive Developing our Assistive Technology (AT) ServicesTechnology (AT) Services Work has started in Leeds to develop Work has started in Leeds to develop

some of our existing AT services and some of our existing AT services and better coordinate AT services across the better coordinate AT services across the citycity For LCES, this means implementing our For LCES, this means implementing our

preferred optionpreferred option For Telecare, it broadly means service For Telecare, it broadly means service

expansionexpansion

Assistive Technology (AT) Assistive Technology (AT) Services in LeedsServices in Leeds We also plan to develop an Assistive We also plan to develop an Assistive

Technology HubTechnology Hub The AT Hub will operate as a single point of The AT Hub will operate as a single point of

contact for all service users, enabling us to:contact for all service users, enabling us to: Provide a universal AT offer, including for self-fundersProvide a universal AT offer, including for self-funders Provide straightforward access to all AT provisionProvide straightforward access to all AT provision Promote greater understanding of what various AT can Promote greater understanding of what various AT can

do via information, advice and trainingdo via information, advice and training Provide personalised AT;Provide personalised AT; integral to overall care integral to overall care

packages packages